Organization
AMANDA CERQUEIRA, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSE DANIEL CERQUEIRA (OFFICE MANAGER)
(910) 458-3232
Entity
Organization
Contact information
Practice address
1328 N LAKE PARK BLVD, STE. 107, CAROLINA BEACH, NC 28428-3935
(910) 458-3232
(910) 458-3253
Mailing address
1328 N LAKE PARK BLVD, STE. 107, CAROLINA BEACH, NC 28428-3935
(910) 458-3232
(910) 458-3253
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7597
NC
Other
Enumeration date
01/15/2008
Last updated
01/15/2008
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